It’s that time of year. The time when we bake cookies and fudge and tasty pies. The time when the workplace break room is littered with holiday candy and plenty of chocolate. It’s a time when it feels almost obligatory to feed the sweet tooth. But what if you’re pregnant? Does pregnancy give you an eat-all-you-want pass with the holiday sweets? The short answer is no. But then again, as with most anything, it’s all about balance.
We as midwives make nutrition an important part of the care we offer pregnant clients. It’s the hallmark of good prenatal care. To help pregnant women navigate this holiday season, we asked a seasoned midwife/educator/author to share her tried and true pregnancy diet, a diet based on a modified American Diabetes Association (ADA) diet, with specific portion sizes and an accompanying chart. The best part? Desserts are not off-limit, although one piece of pie could blow a lot of the small, allowed portions.
Juliana Van Olphen-Fehr, CNM, PdD, retired director of the Shenandoah University nurse-midwifery program and author of Diary of a Midwife, spent an entire prenatal visit on nutrition when she had a combination home/hospital practice. Clients often joked that subsequent prenatal visits were diet confessionals; some tried to hide ice cream cones from her view when running into her outside of appointments. The nutrition prenatal session left its indelible mark on the pregnant women she served and the Fehr pregnancy diet was a hallmark of her successful practice.
Recently, we asked her if her opinion on the optimal pregnancy diet had changed all these years later: “No. Not one bit…. You are what you eat, so when you’re pregnant, so is the baby [what you eat]. What your job is, when you’re pregnant, is to nourish that body and really make sure that the body inside you will grow up to be an incredible and productive human being.”
Dr. Fehr frames the pregnancy diet in both biological and historical perspectives. Our brain requires glucose. “It doesn’t use protein and vitamins. Glucose is it. And now the pregnant woman has two brains and one is really changing fast. It’s growing and it’s interested in getting all the nutrition it needs.” Yet, historically, humans’ access to sugar was seasonal and typically fruit, or at the very least, lactose, another sugar, from a cow’s milk.
“Humans were designed to survive despite the lack of access to sugar. That’s what we were meant to do, because [historically] we didn’t have it. The problem is that evolution takes thousands of years to develop. We now have so much access to sugar; we are inundated with it. We need it. We crave it.”
But at some point the pancreas won’t keep up with a contemporary intake of sugar. And that creates problems for both the baby and the mother.
Every day a pregnant woman needs grains and carbohydrates to offer the brain the sugar it needs. But the trick is to keep track of serving sizes and amounts. A pregnant woman and her growing baby needs:
- 9 servings of carbohydrates
- 9 servings of protein
- 3 servings of milk
- 3 servings of vegetables
- 6 servings of fruit
- 5 servings of fat
And the serving sizes are small: 1 ounce of meet or cheese, 1 egg, or 2 tablespoons of nut butter meet the protein serving requirement. And nut butters also count for 2 of the fat exchanges. Vegetable serving sizes are ½ cup cooked or 1 cup raw. One half of a bagel, 1/3 cup cooked lentils, 1 small potato, or 2 cups cooked pasta meet the carbohydrate serving size requirement.
So where does that leave a pregnant woman during the holidays? A little bit of good math, planning, and awareness go a long way. Enjoy that pie, but be mindful of the carb, dairy, fruit, and fat exchanges. Enjoy that piece of fudge, but pull back on your dairy and fat servings for the remainder of the day. And be sure to fill the rest of your day with all of the nutrients that are most important for you and your growing baby. You’re eating for two. Two brains, two pancreases, one of each that are still growing and developing. A good diet is an investment in your own health and in the long-term health of your baby. Cheers!